Sexually Transmitted Diseases

Skip Navigation LinksHome > December 2007 - Volume 34 - Issue 12 > Education Attainment and the Risk of HIV-1 Infections in Rur...
Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e31813e0c15
Article

Education Attainment and the Risk of HIV-1 Infections in Rural Kilimanjaro Region of Tanzania, 1991–2005: A Reversed Association

MMBAGA, ELIA J. MD, MPH*†; LEYNA, GERMANA H. MD, MPH*‡; MNYIKA, KAGOMA S. MD, PhD*; HUSSAIN, AKTHAR MD, PhD†; KLEPP, KNUT-INGE MPH, PhD‡

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Abstract

Objective: Previous studies found educated individuals to have higher risk of human immunodeficiency virus (HIV)-1 infection in Africa. A reverse in this association was predicted. We investigated the change in this association from 1991 to 2005 in a rural population in Tanzania.

Study Design: Two cross-sectional surveys were conducted in 1991(N = 1152, response rate 76.4%) and 2005 (N = 1528, 73.0%). Consenting individuals aged 15 to 44 years living in Oria village were interviewed and gave blood for HIV-1 testing.

Results: Primary [adjusted odds ratio (AOR), 2.7; 95% confidence interval (CI): 1.3–20.0] and secondary/higher education (AOR, 4.5; 95% CI: 1.4–24.9) were associated with increased risk of HIV-1 infection in 1991. A reversed association was observed in 2005 where reduced odds of infection were associated with primary (AOR, 0.5; 95% CI: 0.2–0.8) and secondary/higher education (AOR, 0.4; 95% CI: 0.3–0.9). This was most pronounced among educated men. Corresponding reduction in risk behaviors were observed. Increased odds of reporting ever use of condom (AOR, 2.8; 95% CI: 1.1–7.3) and 70% reduction in reporting ≥2 sexual partners in the past year was observed among educated women. Educated men reported 60% reduction in the odds of reporting ≥2 sexual partners in the past month preceding the last survey.

Conclusions: A reversed association between education attainment and HIV-1 infection was observed in this population between 1991 and 2005. Education seems to have an empowering role in women. Decreased risk among educated men may have an impact on HIV-1 transmission. Improving education sector in rural areas might be instrumental in the fight against the HIV epidemic.

© Copyright 2007 American Sexually Transmitted Diseases Association

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